Change pain

I spent much of Sunday evening in A&E. Nothing serious – just the average sort of flesh wound you come to get used to when living with toddler siblings who’ve just worked out the basics of projectiles.

The children’s department was unusually busy, and so I had quite a few hours to look at the sign above that was posted in a couple of places in the waiting area, along with copies in every one of the cubicles.

On the night, it was the oxymoronic nature of the notice that tickled me – something designed to speed things up having the effect of slowing things down.

But thinking about it since, it strikes me as really poor change management from a number of perspectives.

Introducing new systems into a setting is inevitably going to result in less effective working for a period of time whilst people get used to the new practices. In an environment like a casualty ward, getting through that without impacting front line services seems to me like a basic design consideration.

It’s not like you see the likes of Amazon putting up notices to say they’re putting a few new things in, so expect some delays. Why should that be tolerated in a time-critical (and without doubt sometimes life-and-death) environment? Designing the process of change to be invisible at the front line is an absolute.

But, moreover, putting signs like this up all over the place becomes a self-fulfilling prophesy.

I remember in my years of consulting spending some time at a Best Western hotel in the centre of Cambridge. In this case it was misnamed in two dimensions.

Amongst the horrors of the experience was a laminated notice in the bedroom that informed guests that many of the staff did not have English as a first language and as a result guests were requested to “speak slowly and clearly when issuing instructions”. Not only did this represent a fundamental recruitment issue for the institution, but it also I’m sure was in part responsible for their terribly demotivated and unwelcoming staff.

Were all the delays that I experienced on Sunday night as a result of the new computer system? Categorically “no”. There was a four-page form that I had to complete on arrival when my son was in his most distraught phase, most of which appeared to be checking that he was eligible to receive treatment and wasn’t a foreigner (thank you Mr Farage for all that you have done, you petty-minded pillock). But the delays experienced, according to the wonderful consultant we eventually got to see, were due to unprecedented demand.

The signs up all around the hospital, however, were saying something completely different. There are enough challenges in introducing change in healthcare without handicapping your project like this…